Ear melanoma is a type of skin cancer that develops on the ear. Early diagnosis and treatment can result in positive outcomes.

Melanoma can develop anywhere on the skin, including the outer ear. According to the American Cancer Society, the neck and face are common areas for melanoma.

Melanoma forms when melanocytes grow uncontrollably. Melanocytes are cells that give skin its pigmentation.

Melanoma is not as common as other types of skin cancer but can be more dangerous because, without treatment, it can spread easily to other areas of the body.

This article looks at ear melanoma symptoms, diagnosis, treatment, and outlook.

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A key symptom in melanoma is a mole or spot that changes in size, color, texture, or shape or looks different from other marks on the skin.

People can check for abnormal signs of a mole, spot, or birthmark with the ABCDE guide:

  • Asymmetry: One half does not look the same as the other.
  • Border: It has blurred, irregular, or uneven edges.
  • Color: The color within the mark varies and may include shades or patches of brown, black, red, pink, white, or blue.
  • Diameter: The diameter is more than 6 millimeters, about the size of a pencil eraser.
  • Evolving: It changes in size, color, or shape.

Other symptoms of ear melanoma may include:

  • a sore that does not heal
  • pigment that spreads beyond the border of the mark to the skin around it
  • swelling or redness beyond the border of the mark
  • itching, pain, or tenderness
  • a mark that is scaly, oozing, or bleeding
  • a lump or bump

If people notice any of these changes on their ear, or any other unusual symptoms, they can speak with a doctor.

Melanoma develops due to genetic changes that cause cells to grow out of control. People may inherit or acquire these genetic changes.

Ultraviolet (UV) rays are one of the main causes of melanoma. UV rays come from sunlight and artificial sources, such as tanning beds.

UV rays can damage the DNA in skin cells and cause them to grow abnormally, and they may become cancerous.

The skin on the ear is thin and may have increased exposure to high levels of UV light, which can increase the risk of melanoma.

Less commonly, people may inherit certain genetic changes that increase their melanoma risk.

According to a 2020 case review, research has found ear melanoma more common in males, people with fair skin, and people in their 60s. Those with frequent exposure to sunlight, such as those working outdoors, may also have an increased risk.

The research also suggests that those without hair covering the ears may have an increased risk of ear cancer, as the hair may offer some protection against the sun.

Other risk factors for melanoma include:

  • exposure to natural or artificial sunlight, such as tanning beds
  • exposure to certain environmental factors, including radiation and solvents
  • a history of multiple blistering sunburns, particularly in childhood or adolescence
  • being white
  • a family history of abnormal moles
  • a personal or family history of melanoma
  • having genetic changes which increase the risk of melanoma
  • having many moles on the skin
  • having a weakened immune system

To diagnose ear melanoma, a doctor may carry out the following investigations:

  • a personal and family medical history, and an assessment of any risk factors
  • a physical exam to assess symptoms on the ear, check for melanoma in other areas of the body, and check the lymph nodes for any swelling
  • dermoscopy, which uses a specialized magnifying lens to examine the skin
  • reflectance confocal microscopy (RCM), which uses a laser and microscope to examine the layers of the skin to look for abnormalities
  • skin biopsy, which removes a small sample of skin for laboratory testing to check for cancer cells

If a doctor suspects melanoma has spread, they may also take blood tests and use imaging scans to view structures inside the body.

Treating ear melanoma is similar to treating other types of melanomas on the skin.

According to a 2018 article, surgery is the most common treatment for ear melanoma, with radiotherapy the second most common.

Surgery for ear melanoma involves removing the melanoma, as well as an area of healthy tissue around the cancer to ensure no cancer cells remain.

A surgeon may remove a smaller area compared to other melanoma surgeries to preserve more of the ear, such as cartilage and connective tissue.

A surgeon may replace the skin they remove with a skin graft, which uses skin from another area of the body to repair a wound.

If melanoma has spread to the lymph nodes, a surgeon will also remove any cancerous lymph nodes.

Radiotherapy uses radiation to destroy cancer cells and prevent the cancer from growing. People may have external radiotherapy to treat melanoma, which uses a machine to deliver radiation to the affected area.

Other treatments for ear melanoma may include:

According to the 2020 review, early diagnosis and treatment are important in improving the outlook. The type of melanoma may also affect the outlook.

Diagnosing and treating melanoma early can increase the likelihood of curing the cancer and preventing it from spreading.

Factors such as age, overall health, and the response of the cancer to treatment can also affect outlook.

Below are answers to some frequently asked questions about melanoma.

Is melanoma on the ear common?

Melanoma of the external ear is rare and accounts for 1–4% of cases of primary skin melanomas.

A 2017 study states that 25% of melanoma cases affect the head and neck, and melanoma of the external ear accounts for around 7–20% of these.

Melanoma of other parts of the ear, such as the middle ear and eustachian tube, are very rare.

What are the warning signs of ear cancer?

Warning signs of ear melanoma include any abnormal changes to the skin on the ear, such as:

  • a lump or bump
  • a sore that does not heal
  • a new mark, spot, or mole
  • a mark with abnormal or changing color, texture, shape, or size
  • a mark that oozes, bleeds, or is scaly, itchy, or painful

Melanoma is a skin cancer that can form on any area of the body, including the ear. Ear melanoma can appear as an abnormal mole or mark on the skin.

It is important to contact a doctor as soon as possible about any unusual moles, blemishes or changes to the skin of the ear.

Early diagnosis and treatment of melanoma can increase the chance of curing the cancer and preventing it from spreading. Melanoma that has not spread has a good outlook.